Referrals to Specialists: An exploratory investigation of referrals by 13 General Practitioners to medical and surgical departments

Abstract

Several aspects of referrals to medicine and surgery of National Health Service (NHS) patients in thirteen Dutch General Practices were investigated. In The Netherlands active and passive referrals have to be separated. Only one out of three referrals to medicine was an active referral on the initiative of the GP. With regard to surgical referrals about half were active referrals. About half the passive referrals were referrals in retrospect. The thirteen GPs differed in the percentages of active and passive referrals.

There was a strong positive correlation between the percentages of passive referrals to medicine and surgery (Spearman Rs =. 81). The correlation between the percentages of repeat cards for both groups of specialists was almost as strong (Spearman Rs =. 73).

In four out of five active referrals the GPs informed the specialist about some aspects of the referral, usually by letter and rarely by telephone. GPs who sent information along with a referral to medicine often did the same with a referral to surgery (Rs =. 60).

The legibility of the written information was, in general, moderate to poor. Only occasionally the GPs formulated clearly what they expected from the specialist.

Suggestions are formulated to improve the referral process between primary and secondary care.

Key Words:

• general practice
• surgical referrals
• referrals to medicine